Sunday, February 27, 2011

Radiesse is an injectible filler made of calcium hydroxylapatite microspheres, which has the same chemical constituent of teeth and bone.

Radiesse has been approved by the FDA on December of 2006 for correction of moderate to severe facial wrinkles and folds, such as the nasolabial fold.

When Radiesse is injected into soft tissue, such as the dermis, this causes fibroblasts proliferation and new collagen formation.

Pre-clinical studies have shown that Radiesse was shown to be non-toxic, non-mutagenic, non-antigenic and non-irritating.

The clinical outcome of Radiesse is expected to last up to 12-24 months.

Potential Complications of Radiesse

The most common adverse event requiring clinical intervention after injection with Radiesse was the development of nodules of the lip. This typically occurs within 6 to 12 weeks after injection into the lips.

12.4% of patients in one study developed lip nodules after injection for lip augmentation.

Treatment of the nodules can range from massage therapy, steroid injection to surgical excision of the nodules.

Injection into the tiny vessels of the face may occur with any dermal filler. Although this complication is rare, intraarterial embolization of any dermal filler may cause necrosis of the face, and even blindness.

Lumps may occur after Radiesse injection, especially after intramuscular injection such as the orbicularis oculi (muscles around the eye.)

Before one undergoes a simple non-invasive procedure, such as a Radiesse injection, one should be informed about the possible adverse outcomes that can potentially happen. I recommend asking your plastic surgeon for any questions about Radiesse prior to undergoing this procedure.

Saturday, February 26, 2011

I encourage the readers of this blog to help support SMILE TRAIN, one of the non-profit Cleft Charity Organizations. "Smile Train is the world's leading cleft charity with thousands of partners and programs operating in 78 countries, including some of the world's poorest. " The organization's mission is to help the millions of children in developing countries who are suffering with unrepaired clefts. Please visit their facebook website SMILE Train.

Friday, February 18, 2011

One of the plastic surgery procedures I enjoy is cleft lip/palate repair. I would like to ask the visitors of this blog to help support The SMILE TRAIN, a non-profit Cleft Charity Organization. Please visit their facebook website: SMILE TRAIN

Thursday, February 17, 2011

The use of sunscreen after undergoing a facial plastic surgery procedure, such as LASER skin resurfacing and facial chemical peels, is probably one of the most effective moisturizer additive. Inflammation from a facial plastic surgery procedure can cause hyperpigmentation, especially with sun exposure. Sunscreen is an effective moisturizer additive since it has the ability to prevent and reverse photoaging. It is also an important part of facial post-surgical skin care since it can prevent skin hyperpigmentation (darker skin pigmentation). Hyperpigmentation may occur since the presence of UVA radiation can stimulate the production of melanin by melanocytes (cells producing pigment in skin.)

Fast Facts about Sunscreen

Chemical ingredients found in sunscreen undergo a chemical transformation that absorbs UV radiation and turn it into heat. This process is irreversible, rendering the sunscreen inactive once it absorbs UV radiation.

Thus, the frequent use of sunscreen is important.

Sunscreen ingredients can be divided into UVA (320-360nm) and UVB (290-320nm) absorbers.

Tuesday, February 15, 2011

Lymphedema is swelling of the limbs caused by abnormal build up of fluids in the body. This may occur after breast cancer surgery, such as a mastectomy (removal of the breast) and axillary node dissection (surgery to remove the lymph nodes at the arm pit area.)

Extensive surgery of the axilla (arm pit area) increases risk for lymphedema of the arm.

Radiation therapy to the axilla also increases risk for arm lymphedema.

Up to 38% of patients who undergo axillary dissection for breast cancer and radiation therapy may develop lymphedema (swelling) of the arm

Most patients can be treated with no need for surgery.

Patients with lymphedema are at increased risk of developing an infection of the arm, such as cellulitis.

Precautions to take to avoid an infection of the arm when one has lymphedema :

Make every attempt to avoid cuts, scratches, hangnails, insect bites and burns.

If you or your family has a history of arm lymphedema after breast cancer surgery, I recommend to ask one of your Houston Plastic Surgeons whether liposuction of the arm with lymphedema is right for you.

Tuesday, February 8, 2011

Medications That Cause GynecomastiaThere are several pharmacologic agents or medications that could cause gynecomastia. Although the risk of male breast enlargement secondary to certain medications are very low, one should be aware of which drugs can cause gynecomastia.

The following drugs are associated with gynecomastia:

Marijuana (Cannabis sativa)

Androgens as found in anabolic steroids

Estrogen containing medications

Stilbestrol - medication used to treat prostate cancer

Anti-androgen medications

Chorionic gonadotropin

Diazepam

Digitalis

Ergotamine

Hydantoin

Hydroxyzine

Isoniazid

Lunesta

Methyldopa

Meprobamate

Pepcid

Tagamet

Reserpine

Spironolactone

I recommend consulting your primary care physician regarding these medications if gynecomastia is a major concern for you. If your medical doctor decides to stop the medication, the breast enlargement may go away. One should not stop taking their medications without the consultation of your physician.

Sunday, February 6, 2011

The incidence of ALCL of the breast is very low according to a European study: 0.1 to 0.3 per 100,000 women with breast implants per year.

There is currently no consensus regarding the treatment protocol for ALCL of the breast since there has been very few cases worldwide. The prognosis has been excellent based on the study conducted at the University of Texas M.D. Anderson Cancer Center.

Friday, February 4, 2011

Disclosure: Dr. De La Cruz has no financial disclosure or association with Allergan. These photographs were included to educate patients about hyaluronic acid dermal fillers. Photograph courtesy of Allergan.

There are many options that are available to treat the tear trough deformities. These include: fat injections, malar implant/prosthesis, pedicled fat, hyaluronic acid dermal filler injections, etc. The advantages of using hyaluronic acid injections, such as Juvederm and Restylane, are that this method avoids the downtime of surgical options and is minimally invasive.

The dermal filler is injected at the level of the periosteum (tissue above the bone) to reduce the risk of palpability and surface irregularities.

Surface irregularities from dermal filler injections occur when these injections are done superficially, such as the superficial & deep dermis of the skin, subcutaneous (tissue under the skin) or suborbicularis oculi fat (fat underneath the lower eyelid muscle, orbicularis oculi).

Injection at the level of the periosteum improves the longevity of the filler since it is placed where the tissue is not mobile.

Like any dermal filler injections, the treatment of tear trough deformities using dermal fillers, such as Restylane, Juvederm or even Radiesse, may last for several months depending on which dermal filler is used.

According to a recent study, the results lasted from 6 to 12 months.

A dermal filler injection for tear trough deformities is not for everyone. A transconjunctival blepharoplasty for the lower eyelid or other procedures may be necessary.

I recommend these treatments to be performed by one of your Houston plastic surgeons who will determine whether a dermal filler injection is right for you. Choosing a medical provider who has a solid knowledge of the anatomy of the face, and has good surgical judgment is essential to minimize the potential complications (such as blindness and facial necrosis) that may arise from a dermal filler injection. Your plastic surgeon will guide and recommend you the best possible treatment option for your tear trough deformity problem.

Thursday, February 3, 2011

Note: Dr. De La Cruz has no financial disclosures and association with Allergan. The photos are presented to educate patients who are interested in having an injection with BOTOX for facial rejuvenation. Photographs courtesy of Allergan.

Wednesday, February 2, 2011

BOTOX Injection for the Wrinkles in Between the Brows (Glabellar Frowns)

If your frown in between your eyebrows is visible only in motion, the result of treatment may well be a good one.

If the furrow is present at rest, then your wrinkles may not be completely eliminated.

If you have heavy brows (seen especially in men), treatment of your frown in between your eyebrows may increase the sagging toward the middle (medially).

Are your brows not symmetric in motion?

If so, the results of your BOTOX treatment will be not be symmetrical too unless this is taken into account.

Do you have an active frontalis (forehead muscles)?

If so, treatment of your vertical furrow alone may cause the lateral brow (brow on the side) to elevate, creating an unattractive peaking of the brows.

You may need a different treatment or your full forehead zone treated.

BOTOX injection treatment requires a solid knowledge of the anatomy of the face, as well as good judgment by your medical provider. I recommend asking one of your Houston cosmetic surgeonsfor any questions if you are a good candidate for BOTOX treatment.

One of my plastic surgery colleagues and friends from Loma Linda University, Dr. Allen Gabriel, recently conducted a study to determine whether the use of Botox could help alleviate the pain after undergoing a mastectomy (complete removal of the breast) and breast reconstruction in breast cancer patients. The study showed that patients who underwent Botox injections into the chest wall muscles after surgery were reportedly more comfortable and experienced less pain post-operatively than those patients who only received saline injections.

Randomized clinical study involving patients who underwent mastectomy and breast reconstruction with tissue expanders showed that those women who received Botox were far more comfortable after surgery than those who received placebo.

No significant difference in the use of narcotic, muscle relaxants, or anti-inflammatory drugs were observed in patients who received Botox and the placebo group in the first 3 days after surgery.

Patients who received Botox had less pain, and used significantly fewer doses of narcotics and muscle relaxants 7 to 45 days after surgery (P<0.05).

I recommend to ask one of your Houston Plastic Surgeons if they use Botox in their practice as an adjunct to reduce post-operative pain after breast reconstruction with tissue expanders.

Tuesday, February 1, 2011

Having extra nipples (often known as a third nipple) or polythelia is often mistaken for moles by many. Approximately 1 in 18 humans would have an extra nipple. These extra nipples are usually found along the two vertical “milk lines” which can vary in number from one to as many as eight or more. One should be aware that the presence of “extra nipples” or polythelia has a strong association with kidney disease.

Supernumerary nipples from the work of Erik Strandberg (Wikimedia commons)

Fast Facts about Polythelia

There may be a possible relationship with mitral valve prolapsed (heart valve problem).

14% of patients with no family history of polythelia have kidney abnormalities

32 % of patients with a family history of polythelia have kidney abnormalities

1-2% of general population may have kidney abnormalities.

19% of patients who had kidney cancer had extra nipples.

I recommend that physicians, families and friends of individuals who have "extra nipples" should be aware of the association of kidney abnormalities with polythelia. Routine physical examination, a renal ultrasound and urinalysis may be recommended in these patients.

Subscribe To This Blog: The Woodlands Plastic Surgeon

Silicone Gel Breast Implant or Saline Breast Implant?

Total Visitors

Visitors from All Over the World

Website Links

LIKE US on Facebook

The Woodlands Plastic Surgeon

Disclaimer: This is NOT an active plastic surgery practice website advertisement. This blog's main purpose is to provide information of a general nature related to plastic surgery. I believe that patient education is extremely important prior to undergoing any procedure.

Search This Blog

About Me

Dr. De La Cruz, a Asian American, entered college at the age of fifteen and received his bachelor’s degree from Texas Tech University where he graduated summa cum laude, majoring in Cellular and Molecular Biology.
Following four years of medical school training in Houston at the University of Texas where he earned the Frank Webber Prize in medical research, Dr. De La Cruz spent the next several years in California where he successfully completed a rigorous training in general surgery at Loma Linda University.
Dr. De La Cruz developed the “Celtic cross technique” for immediate umbilical reconstruction which was published in the Journal of Plastic, Reconstructive & Aesthetic Surgery. He was subsequently board certified by the American Board of Surgery.
Dr. De La Cruz pursued further training in Plastic surgery at Medical College of Georgia where he honed his skills in reconstructive plastic & cosmetic surgery. During his training, he served as Chief Surgery Resident in Plastic Surgery, and scored 94th percentile nationally on his Plastic Surgery Inservice Examination.

Share it

The Woodlands Plastic Surgeon: Copyright December 2010. Powered by Blogger.

The Woodlands Plastic Surgeon: Disclaimer

This blog website is NOT an active plastic surgery practice advertisment. Emmanuel De La Cruz M.D. offers and maintains this web site to provide information of a general nature related to plastic surgery. The information is provided with the understanding that Emmanuel De La Cruz M.D. is not engaging in rendering surgical or medical advice or recommendations. Any information in the publication, messages, postings, or articles on this web site should not be considered a substitute for consultation with a Plastic Surgeon to address individual medical needs.